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Early changes in brain structure, functional connectivity and neuropsychiatric symptoms after HCV infection cure with direct-acting antivirals

Published online by Cambridge University Press:  13 August 2021

M. Cavero ,
Z. Mariño ,
R. Navines ,
J. Pariente ,
E. Muñoz Moreno ,
C. Bartres ,
L. Nacar ,
S. Lens ,
S. Rodriguez-Tajes  and
S. Cañizares
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M. Cavero*
Affiliation:
Psychiatry And Psychology Department, Centro De Investigación Biomédica En Red En Salud Mental (cibersam), Institut D’investigacions Biomèdiques August Pi I Sunyer (idibaps), Universitat Barcelona (ub), Hospital Clinic, Barcelona, Spain
Z. Mariño
Affiliation:
Liver Unit, Hospital Clinic Barcelona, CIBERehd, Institut d’Investigació Biomédica August Pi i Sunyer (IDIBAPS), Universitat Barcelona(UB), Barcelona, Spain
R. Navines
Affiliation:
Psychiatry And Psychology Department, Centro De Investigación Biomédica En Red En Salud Mental (cibersam), Institut D’investigacions Biomèdiques August Pi I Sunyer (idibaps), Universitat Barcelona (ub), Hospital Clinic, Barcelona, Spain
J. Pariente
Affiliation:
Magnetic Resonance Image Core Facility, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
E. Muñoz Moreno
Affiliation:
Magnetic Resonance Image Core Facility, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
C. Bartres
Affiliation:
Liver Unit, Hospital Clinic Barcelona, CIBERehd, Institut d’Investigació Biomédica August Pi i Sunyer (IDIBAPS), Universitat Barcelona(UB), Barcelona, Spain
L. Nacar
Affiliation:
Psychiatry And Psychology Department, Centro De Investigación Biomédica En Red En Salud Mental (cibersam), Institut D’investigacions Biomèdiques August Pi I Sunyer (idibaps), Universitat Barcelona (ub), Hospital Clinic, Barcelona, Spain
S. Lens
Affiliation:
Liver Unit, Hospital Clinic Barcelona, CIBERehd, Institut d’Investigació Biomédica August Pi i Sunyer (IDIBAPS), Universitat Barcelona(UB), Barcelona, Spain
S. Rodriguez-Tajes
Affiliation:
Liver Unit, Hospital Clinic Barcelona, CIBERehd, Institut d’Investigació Biomédica August Pi i Sunyer (IDIBAPS), Universitat Barcelona(UB), Barcelona, Spain
S. Cañizares
Affiliation:
Psychiatry And Psychology Department, Centro De Investigación Biomédica En Red En Salud Mental (cibersam), Institut D’investigacions Biomèdiques August Pi I Sunyer (idibaps), Universitat Barcelona (ub), Hospital Clinic, Barcelona, Spain
N. Bargallo
Affiliation:
Magnetic Resonance Image Core Facility, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
X. Forns
Affiliation:
Liver Unit, Hospital Clinic Barcelona, CIBERehd, Institut d’Investigació Biomédica August Pi i Sunyer (IDIBAPS), Universitat Barcelona(UB), Barcelona, Spain
R. Martin-Santos
Affiliation:
Psychiatry And Psychology Department, Centro De Investigación Biomédica En Red En Salud Mental (cibersam), Institut D’investigacions Biomèdiques August Pi I Sunyer (idibaps), Universitat Barcelona (ub), Hospital Clinic, Barcelona, Spain
*
*Corresponding author.

Abstract

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Introduction

Hepatitis C virus (HCV) infection is known to be associated with neuropsychiatric manifestations as part of the disease. Previous neuroimaging studies showed brain connectivity dysfunction among HCV-infected patients

Objectives

To assess, by MR in resting state, the potential structural and connectivity changes before (BL) and after HCV eradication (FU12) with direct-acting antivirals (DAA), along with clinical parameters.

Methods

Twenty-one HCV-patients, aged≤55 years, without psychiatric history, nor advanced liver disease, and eligible for DAA, and 25 healthy controls were included. Evaluations were performed at BL and FU12. Brain volume and local gyrification index (LGI) were assessed in MR-T1, and functional connectivity by seed-based analysis (left insula). Depression (MADRS/PHQ9) and neurotoxicity symptomatology (NRS) were assessed. We compared patients between BL/FU12, and controls by means of paired/independent T-test analysis.

Results

Substained virologycal response was obtained in all patients (100%). Depressive and neurotoxicity symptomatology improved after cure (p<0.01). HCV-patients showed a reduced volume in a right latero-occipital area compared to controls (CWP<0.005) in both BL and FU12. This difference was smaller between FU12 and controls. LGI was higher in FU12-HCV compared to BL-HCV. fMRI connectivity showed a high association between insula and occipital/parietal territories in patients than controls, being higher among BL-HCV and controls. Differences were limited to occipital areas among FU12-HCV and controls.

Conclusions

Neuropsychiatric symptomatology improved after cure. Left insula is altered among HCV-patients in structured and connectivity (mainly occipital areas). After cure differences with controls were reduced, suggesting a partial restoration of brain connectivity.

Keywords

Hepatitis C virus (HCV)functional connectivityNeuropsychiatric symptoms
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S254
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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